耳穴解郁组穴贴压促进气郁体质产妇泌乳的临床研究
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摘要
目的评价耳穴解郁组穴贴压促进气郁体质自然分娩产妇产后泌乳,缩短泌乳始动时间,提高泌乳量、泌乳率,改善气郁症状积分的作用。方法采用随机、单盲、平行对照的方法,将自然分娩的气郁质产妇90例分为观察组和对照组。观察组45例,对照组45例(脱落1例)。在标准护理的基础上,观察组产后2 h耳穴贴压解郁组穴(胸区、乳腺穴、神门、内分泌、皮质下、肝、胆),同时对照组贴压假耳穴(轮4、轮2、轮1、轮5、耳尖、角窝中、垂前),治疗3 d,观察产妇泌乳始动时间、泌乳量、泌乳率和气郁证症状积分。结果 2组产妇泌乳始动时间差异有统计学意义(P <0.05),泌乳量组间无显著性差异,中医症状积分2组间有显著差异(P <0.01),观察组于产后24 h、对照组于产后48 h泌乳率达到100%。结论耳穴解郁组穴贴压能够促进气郁体质自然分娩产妇产后泌乳,可改善产妇气郁症状,缩短泌乳始动时间,提高24 h泌乳率,但对提高泌乳量的作用不显著。
Objective To evaluate the ef fect of auricular points application with "qi depression group acupoints"on lactation of natural delivery women. To evaluate the ef fect of auricular acupoint pressing on promoting postpartum lactation of parturients with qi depression constitution, shortening the starting time of lactation, increasing lactation yield and lactation rate, and improving the integral of qidepression symptoms. Methods 90 cases of natural delivery women with qi depression syndrome were randomly divided into observation group(45 cases) and control group(45 cases and 1 case dropped of f). All of them accepted the same therapy, and observation group was pressed on the auricular points(chest area, breast acupoint, Shenmen, endocrine, subcortex, liver and gallbladder), the control group pressed onthe pseudoauricular points(helix4, helix2, helix1, helix5, ear apex, middle triangular fossa, anterior ear lobe). Each acupoint was pressed 10 ～ 15 seconds before feeding, 4 days for a course. The initial time of lactation,lactation volume, lactation rate and symptom integral were observed. Results There was no significant dif ference in the amount of lactation between the two groups. There was a significant dif ference in the scores of TCM symptoms between the two groups(P < 0.01). The lactation rate of the observation group was 100% at 24 hours postpartum and that of the control group was 100% at 48 hours postpartum. Conclusion Auricular acupoint application with "qi depression group acupoints" can promote postpartum lactation of parturients with qidepression constitution, improve the symptoms of qi depression, shorten the starting time of lactation and increase the 24-hour lactation rate, but it has no significant ef fect on improving the lactation volume.
Objective To evaluate the ef fect of auricular points application with "qi depression group acupoints"on lactation of natural delivery women. To evaluate the ef fect of auricular acupoint pressing on promoting postpartum lactation of parturients with qi depression constitution, shortening the starting time of lactation, increasing lactation yield and lactation rate, and improving the integral of qidepression symptoms. Methods 90 cases of natural delivery women with qi depression syndrome were randomly divided into observation group(45 cases) and control group(45 cases and 1 case dropped of f). All of them accepted the same therapy, and observation group was pressed on the auricular points(chest area, breast acupoint, Shenmen, endocrine, subcortex, liver and gallbladder), the control group pressed onthe pseudoauricular points(helix4, helix2, helix1, helix5, ear apex, middle triangular fossa, anterior ear lobe). Each acupoint was pressed 10 ～ 15 seconds before feeding, 4 days for a course. The initial time of lactation,lactation volume, lactation rate and symptom integral were observed. Results There was no significant dif ference in the amount of lactation between the two groups. There was a significant dif ference in the scores of TCM symptoms between the two groups(P < 0.01). The lactation rate of the observation group was 100% at 24 hours postpartum and that of the control group was 100% at 48 hours postpartum. Conclusion Auricular acupoint application with "qi depression group acupoints" can promote postpartum lactation of parturients with qidepression constitution, improve the symptoms of qi depression, shorten the starting time of lactation and increase the 24-hour lactation rate, but it has no significant ef fect on improving the lactation volume.
引文
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[14]刘一心,黄荣彬,姜海萍,等.深圳市母乳喂养现状及对儿童生长发育的影响[J].中国儿童保健杂志,2006,14(6)574-576.
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[17]赵耀,黄磊,张正,等.2002年北京市2岁以内婴幼儿营养与喂养状况调查[J].中华预防医学杂志,2006,40(1):46-49.
[18]俞桔,周峻.耳穴贴压对产妇泌乳的影响[J].中国针灸,2012,32(12):1087-1089.
[19]韩廷霞,陈晨.耳穴埋豆对剖宫产术后泌乳影响的Meta分析[J].湖南中医杂志,2018,34(11):120-123.
[20]涂序嫣,胡莉琴,钟素琴,等.王不留行耳穴贴压法对产后泌乳不足的影响及机制研究[J].临床医学工程,2012,19(2):249-250.
[21]韩琦,李成国,江春燕,等.耳穴贴压对产后泌乳量及血清泌乳素的影响[J].上海针灸杂志,2013,32(3):189-190.
[22]何军琴,陈宝英,古梅,等.中医对产后缺乳的认识及治疗现状[J].中国中医药信息杂志,2006,13(4):93-95.
[23]张喜红,李苑瑛.通乳汤促进产后泌乳的疗效观察[J].现代中西医结合杂志,2004,13(8):1022-1023.
[24]卞丹妮.中药配合乳房按摩促进产后泌乳的临床观察[D].南京:南京中医药大学,2011:1-34.
[25]张宇,彭巧,廖东霞,等.产后缺乳的病机研究及治疗现状[J].中医药导报,2008,14(5):117-118.
[26]王家良.临床流行病学[M].3版.上海:上海科学技术出版社,2009:165.
[2]YOKOYA M A Y,WADA S,SUGIMOTO M,e t a l.Breastfeeding rates among singletons,twins and triplets in Japan:a population-based study.Twin Res Hum Genet,2006(9):298-302.
[3]王琦.中医体质学[M].北京:人民卫生出版社,2005:128-156.
[4]世界卫生组织,联合国儿童基金会.母乳喂养咨询培训教程[M].中华人民共和国卫生部妇幼卫生司,译.北京:北京医科大学中国协和医科大学联合出版社,1997:4-26.
[5]陈宝艳.中医体质与产后缺乳及证型的相关性研究[J].新中医,2016,48(1):127-130.
[6]谢雁鸣,王永炎,朴海垠.构建中医软指标疗效评价模式的初步探索[J].中国中西医结合杂志,2007,27(6):560-564.
[7]World Health Organization,UNICEF.Global strategy for infant and young child feeding[M].Switzerland:WHOLibrary Cataloguing-in-Publication Data,2003:8.
[8]中华医学会儿科学分会儿童保健学组,中华医学会围产医学分会,中国营养学会妇幼营养分会,等.母乳喂养促进策略指南(2018版)[J].中华儿科杂志,2018,56(4):261-266.
[9]刘晓琴,张晓宁.集束化干预在提高初产妇纯母乳喂养成功率中的应用[J].齐鲁护理杂志,2015,21(14):28-30.
[10]王朕,王欢欢,肖梦杰,等.我国母乳喂养现状与护理对策分析[J].中国生育健康杂志,2018,29(2):200-202.
[11]高燕秋,康楚云,王燕.1998-2003年中国母乳喂养与婴儿过渡期食物添加状况分析[J].中国儿童保健杂志,2006,14(3):220:222.
[12]刘克玲,张德英,王斌,等.中国部分城市婴幼儿母亲的养育行为调查[J].中国妇幼保健,2003,18(2):114-116.
[13]刘萍,乔丽娟,于萍,等.石河子市母乳喂养启动现状及影响因素分析[J].中国妇幼健康研究,2010,21(2):130-132.
[14]刘一心,黄荣彬,姜海萍,等.深圳市母乳喂养现状及对儿童生长发育的影响[J].中国儿童保健杂志,2006,14(6)574-576.
[15]李文,王嫣.上海市黄浦区半凇地区婴儿母乳喂养现状调查分析[J].中华妇幼临床医学杂志,2007,3(1):31-33.
[16]朱翠平,冯正仪.我国婴儿母乳喂养现状与护理干预进展[J].上海护理,2006,6(5):54-56.
[17]赵耀,黄磊,张正,等.2002年北京市2岁以内婴幼儿营养与喂养状况调查[J].中华预防医学杂志,2006,40(1):46-49.
[18]俞桔,周峻.耳穴贴压对产妇泌乳的影响[J].中国针灸,2012,32(12):1087-1089.
[19]韩廷霞,陈晨.耳穴埋豆对剖宫产术后泌乳影响的Meta分析[J].湖南中医杂志,2018,34(11):120-123.
[20]涂序嫣,胡莉琴,钟素琴,等.王不留行耳穴贴压法对产后泌乳不足的影响及机制研究[J].临床医学工程,2012,19(2):249-250.
[21]韩琦,李成国,江春燕,等.耳穴贴压对产后泌乳量及血清泌乳素的影响[J].上海针灸杂志,2013,32(3):189-190.
[22]何军琴,陈宝英,古梅,等.中医对产后缺乳的认识及治疗现状[J].中国中医药信息杂志,2006,13(4):93-95.
[23]张喜红,李苑瑛.通乳汤促进产后泌乳的疗效观察[J].现代中西医结合杂志,2004,13(8):1022-1023.
[24]卞丹妮.中药配合乳房按摩促进产后泌乳的临床观察[D].南京:南京中医药大学,2011:1-34.
[25]张宇,彭巧,廖东霞,等.产后缺乳的病机研究及治疗现状[J].中医药导报,2008,14(5):117-118.
[26]王家良.临床流行病学[M].3版.上海:上海科学技术出版社,2009:165.
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